Mentoplasty, also called Genioplasty or Chinplasty, is a cosmetic surgery procedure carried out to alter the chin, the underlying structure of the face, so as to provide better balance to the facial features. The alteration could involve height reduction or rounding, by osteotomy or increase in its size, using surgical implants. This operation is generally performed with Rhinoplasty, but can also be done separately.
Mentoplasty is done to correct malfunctions of the chin due to developmental abnormalities like, jaw bones growing on one side but not on the other, that leads to facial asymmetry. Another congenital defect that requires Mentoplasty is a missing part of jaw bone. It is required when chin has not grown in proportion to other facial features. It is also done during a gender transition, because, the size and shape of chin is different in men and women. Two other procedures that involve Mentoplasty are craniofacial reconstruction carried out on account of trauma or surgery for cancer, and Orthognathic surgery that involves repositioning of facial bones to improve speech and chewing. Mentoplasty is generally performed only in adults and children whose jaw has grown to its full size.
Mentoplasty is done to increase the size of small or receding chins which is more common. The other type involves reducing the size of large or protruding chins. A complete facial analysis as well as examination of medical history by the surgeon will help in understanding the effectiveness of the surgery.
Chin augmentation may involve placing an implant under the skin or performing a sliding genioplasty. The operation may take 1 ½ hours when done alone but may take 3 hours if combined with Orthognathic surgery or Rhinoplasty.
Chin implants are required for patients with mild or moderate condition of microgenia, called small chin. The implant could be a cartilage taken from donor sites of the same person or could be alloplastic implants like Gore subcutaneous augmentation material whose use reduces the risk of infection. The implant is inserted under the chin (submental) or inside the mouth (intraoral), by cutting through several layers of tissue, with the main nerve remaining untouched. The surgeon then creates a slot, called pocket, in the connective tissue inside the chin and washes the area with antiseptic solution before placing the implant in the pocket. After this, the incisions are closed with Steri-strips.
A sliding genioplasty is performed on patients who are not candidates for chin implants because the chin is too small or if the deformity is too complex to rectify. During the procedure, the surgeon cuts through the jaw bone using an oscillating saw and remove a part of the bone. He then moves the bone forward, placing metal plates and screws to fill the gap. After the bone is fixed in its place, the sutures are closed and the patient’s head is covered with pressure dressing.
To reduce the size of an overly large or protruding chin, the surgery is performed by direct reduction or by employing sliding genioplasty. In the first method, the excess bone is removed by submental or intraoral incision. In the second method, the same method as in augmentation is employed with the difference that the bone segment is pushed backward rather than moving forward.
Visible results with improved jaw functions ensure success of the surgery.